Emotional Disorders in Adolescents: A Case Study of a 16-Year-Old

Mood disorders (with cases of suicide)

Cai Congyu is a 16-year-old student currently on a temporary leave from the second semester of high school (Taipei Private Yuda Commercial and Vocational School).
He has interests in playing the piano and board games.
Since childhood, he has suffered from kidney disease, which has limited his ability to exercise, making him relatively quiet during elementary school.
He is shy and hesitant to talk to strangers, often speaking in a very soft voice on the phone.
His parents divorced when he was young, and he has lived with his mother and sister for many years.
In sixth grade, his mother met her current husband (Uncle Xiaojiang), and their family now consists of four members, including himself.
He occasionally meets his father, and after his grandfather passed away in 2016, his aunt has been taking care of him.
During middle school, he began to engage with music and served as an accompanist, which helped him gain confidence and speak louder.
However, upon entering high school, he struggled to adapt to the new environment and felt out of place among his peers.
His teachers had higher expectations for him, hoping to motivate him, which added pressure in class.
When the second semester of his first year began, he did not register for classes.
As his personality became more cheerful, others expected more from him, leading to a strict attitude regarding his failure to register, emphasizing the need for self-discipline.
After a week, his family realized he had not been attending school.
One day, he attempted suicide using bleach and hydrochloric acid but failed, then swallowed 20 acetaminophen tablets.
He was taken to the hospital immediately and was unharmed.
Following this incident, he did not attend school in March and spent his time playing video games, experiencing insomnia at night and poor sleep during the day.
He occasionally faced setbacks or disappointments, leading to episodes of intense crying.
On one occasion, he attempted suicide with a knife at home but was discovered by family members and downplayed his emotions afterward.
At the end of March, during a family gathering, he expressed a desire to play board games with everyone, but due to work commitments the next day, they declined his invitation.
After this rejection, he had a breakdown upon returning home.
When his family tried to talk to him afterward, it triggered a more severe emotional collapse, and he stopped speaking for two weeks, even staying at his late grandfather's house.
In April, his mother and Uncle Xiaojiang were preparing for a performance at their music school, and he expressed a desire to go on stage.
However, he lost confidence during practice and broke down.
Uncle Xiaojiang reassured him that these feelings were not his fault and could be due to hereditary factors affecting him, suggesting that seeing a doctor could help.
After this conversation, he began to speak again and happily played board games.
On the eve of the performance at the end of April, he mentioned that online friends might come to see him, which caused him significant stress and fear of going on stage.
Ultimately, he did not participate in the performance and cried continuously that day.
However, after playing board games with Uncle Xiaojiang's friends, his mood improved significantly.
Currently, his family observes that he lacks good interpersonal skills, and his lazy and untidy personality also poses minor social issues.
He exhibits symptoms similar to social anxiety disorder and may need to be classified as a special education student.
He shows determination in pursuing his interests, but when faced with situations that do not go his way, he displays aggressive expressions or becomes silent, leading to severe emotional breakdowns and crying.
At this point, we are uncertain whether he is a special education student or has a mental illness, and we feel lost without direction.
He is unwilling to seek medical help, and during our conversations, we are unsure of the best approach to support him (whether to accommodate his feelings, which may influence his perception of interpersonal relationships, or to challenge him, which may trigger emotional responses).
We are at a loss and hope that a physician can provide professional assistance.
Thank you.

Mr. Jiang, 30~39 year old female. Ask Date: 2016/05/02

Dr. Song Chengxian reply Psychiatry

Dear Mr.
Jiang,
The current situation of the case is concerning.
Dangerous items at home should be carefully secured, and the guardian should promptly take the case to a psychiatrist or mental health specialist for evaluation.
If the case is resistant to visiting a hospital or seeing a doctor, it may be beneficial to arrange for the individual to meet with a qualified psychologist or psychotherapist.
This will help determine whether the issues are solely related to stress management or if there are underlying emotional or mental health disorders that need to be addressed appropriately.
Additionally, your letter includes the case's name and school.
Since this consultation website is publicly accessible, I recommend that you promptly contact the website administrator to request the removal of your correspondence or the deletion of the individual's name to protect their privacy.
Sincerely,
Dr.
Song

Reply Date: 2016/05/02

More Info

Understanding emotional disorders in adolescents, particularly in the context of a 16-year-old like 蔡叢羽, requires a nuanced approach that considers various factors influencing mental health. Adolescence is a critical developmental stage characterized by significant emotional, psychological, and social changes. In 蔡叢羽's case, several elements contribute to his emotional struggles, including family dynamics, health issues, and social interactions.

Firstly, it's essential to recognize that 蔡叢羽 has a history of kidney disease, which may limit his physical activity and contribute to feelings of isolation or inadequacy. Chronic health conditions can significantly impact a teenager's self-esteem and social interactions, leading to withdrawal or anxiety in social situations. Additionally, the emotional toll of his parents' divorce and the subsequent family dynamics may have created a sense of instability and insecurity in his life. These factors can exacerbate feelings of loneliness and contribute to emotional distress.

The transition to high school is often challenging for many adolescents, and 蔡叢羽's experience seems to reflect this. He has expressed feelings of being out of place and under pressure from teachers and peers. The expectation to perform well academically and socially can lead to heightened anxiety, especially if the individual feels they are not meeting those expectations. This pressure may have contributed to his recent episodes of emotional breakdowns and suicidal ideation.

It's crucial to address the concerning behaviors 蔡叢羽 has exhibited, such as self-harm and suicidal thoughts. These are serious indicators of emotional distress and should not be taken lightly. The fact that he has attempted self-harm and expressed a desire to end his life highlights the urgency of seeking professional help. Adolescents often struggle to articulate their feelings, and their actions may be a cry for help. Therefore, it is vital for his family to take these signs seriously and seek immediate intervention.

In terms of treatment, a multi-faceted approach is recommended. Engaging a mental health professional, such as a child and adolescent psychiatrist or psychologist, is essential for a comprehensive assessment. These professionals can provide a diagnosis and develop a tailored treatment plan that may include therapy, medication, or a combination of both. Cognitive-behavioral therapy (CBT) has proven effective for adolescents dealing with anxiety, depression, and emotional regulation issues. It can help 蔡叢羽 develop coping strategies, improve his self-esteem, and enhance his social skills.

Moreover, family involvement in the therapeutic process can be beneficial. Family therapy can help improve communication, address underlying issues within the family dynamic, and foster a supportive environment for 蔡叢羽. It is also important for his family to educate themselves about mental health and emotional disorders to better understand what he is going through.

In addition to professional help, creating a supportive home environment is crucial. Encouraging open communication, validating his feelings, and providing reassurance can help him feel more secure. It is essential to avoid placing excessive pressure on him regarding academic or social performance, as this may further exacerbate his anxiety.

Lastly, it is important to monitor his safety closely. Ensuring that potentially harmful items are secured and maintaining a watchful eye on his emotional state can help prevent further crises. If he is resistant to seeking help, involving trusted adults or professionals who can communicate with him in a non-threatening manner may encourage him to open up about his feelings and consider treatment.

In conclusion, 蔡叢羽's situation underscores the complexity of adolescent emotional disorders. A combination of professional intervention, family support, and a nurturing environment can significantly impact his recovery and emotional well-being. It is vital to act promptly and compassionately to ensure he receives the help he needs to navigate this challenging period in his life.

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